Public Health Emergency of International Concern (PHEIC)
Polio this week as of 6 December 2017 [GPEI]
:: The Islamic Advisory Group has recently launched a training manual on polio eradication, mother and child health, and immunization.
:: The latest semi-annual status report for the Global Polio Eradication Initiative has been released, covering progress made between January and June 2017.

:: The WHO Executive Board has released a report providing an update on the status of the four objectives of the Polio Eradication and Endgame Strategic Plan.

:: Summary of newly-reported viruses this week:
No new confirmed cases.
Afghanistan: One new wild poliovirus type 1 (WPV1) positive environmental sample, collected from Kandahar province
Pakistan: Two new wild poliovirus type 1 (WPV1) positive environmental samples, one collected from Khyber Pakhtunkhwa province, and one from Sindh province.one new wild poliovirus type 1 (WPV1) case, from Nangarhar province.

Global Polio Eradication Initiative
WHO  2017 :: 36 pages
At the beginning of 2017, progress continued towards each of the Endgame Plan’s four objectives. The world has never been closer to eradicating polio, with fewer cases in fewer areas of fewer countries than at any time in the past.

Pakistan and Afghanistan continued to intensify eradication efforts and implement their respective national emergency action plans, overseen by each country’s head of state. They continued to treat the virus transmission as a single epidemiological block and focused on coordinating activities in both countries.

In Nigeria, and across the Lake Chad subregion, outbreak response persisted in reaction to the detection of wild poliovirus type 1 (WPV1) in Borno in August 2016, Nigeria, the first WPV detected in the country since 2014. It was a sobering reminder of the fragility of progress and of the dangers of subnational surveillance gaps and low-level residual transmission. Although no new cases have been reported from Nigeria since last August, undetected ongoing transmission was assumed in parts of Borno as it remains inaccessible.

In May 2017, confirmation was received of new circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreaks in both the Syrian Arab Republic and the Democratic Republic of the Congo. The emergence of new cVDPV2 in the 12- to 18-month period following the globally coordinated switch from trivalent oral polio vaccine (tOPV) to bivalent oral polio vaccine (bOPV) in April 2016 was anticipated, with the most at-risk areas foreseen to be those with weak health systems, insecurity or inaccessibility. In preparation for the anticipated risks, internationally-agreed outbreak response protocols had been established to rapidly address cVDPV2 in the post-switch era, including by maintaining a global stockpile of monovalent OPV type 2 (mOPV2). An outbreak response is now under way in both countries to rapidly stop these strains. In the Syrian Arab Republic, the same response strategies were employed that successfully stopped a WPV1 outbreak in the same area of the country in 2013/2014.

These outbreaks underscored the continued risk posed by immunity gaps anywhere in the world, more than any risks associated with the vaccine. In areas of adequate immunity levels, surveillance for type 2 polioviruses from any source revealed a steady and rapid decline of these strains’ persistence. These outbreaks are tragic, in particular for the children who have so far been paralysed by these strains, and emphasize the urgent need to fully withdraw all tOPV stock everywhere. By extension, it also highlights the need to fully withdraw all OPV use, once the remaining strains of WPVs (types 1 and 3) have been declared as eradicated.

A global supply constraint of inactivated polio vaccine (IPV) continued to be managed carefully, allocating available supply to areas deemed at highest risk of cVDPV2 emergence. Increasing clinical evidence indicates that fractional dose IPV provides equal (and in a two-dose schedule, even superior) protection to full dose IPV, but this approach is already stretching limited supply.

On containment, the GPEI continued to work with countries to accelerate efforts to identify all facilities retaining poliovirus stock, reduce their number to an absolute minimum and put in place all necessary biosafety conditions to ensure the safe handling of all residual stock.

Polio transition planning will continue to be intensified through 2017. The 16 countries with the greatest polio-funded infrastructure drafted and are finalizing their transition plans. Transition planning and implementation are being conducted in such a manner as to minimize any associated programme-related risks and to ensure that a successful and lasting polio-free world will be achieved as rapidly and efficiently as possible. A post-certification strategy, request by Member States at the May 2017 World Health Assembly, is being developed and will be presented to the World Health Assembly in 2018, specifying the global technical standards that will be needed after the certification of wild poliovirus eradication to maintain a polio-free world.

Thanks to the generous continuing support of the international development community, including Member States (especially the countries where poliomyelitis is endemic and the generous donors to the GPEI) as well as multilateral and bilateral organizations, development banks, foundations and Rotary International, the budget for 2017 for planned activities was fully financed. At an extraordinary pledging moment at the Rotary International convention in June 2017 in Atlanta, USA, numerous public- and private-sector partners from around the world joined Rotary in announcing new commitments, bringing total pledges against the additional US$ 1.5 billion budget to US$ 1.2 billion. Securing a lasting polio-free world will not only be associated with significant humanitarian and global health benefits but also with economic advantages, as eradicating polio worldwide will result in global savings of US$ 50 billion.
Syria cVDPV2 outbreak situation report 25: 6 December 2017
Situation update 6 December 2017
:: No new cases of cVDPV2 were reported this week. The most recent case (by date of onset) is 9 September 2017 from Mayadeen district.
:: The total number of confirmed cVDPV2 cases remains 70.
:: Planning continues for the second phase of the outbreak response. The Syrian Ministry of Health has requested additional doses of mOPV2 and IPV for two further immunization rounds.
::Training of health staff for the assessment of cold chain capacity across the country is ongoing in Damascus. Health staff have been trained on mobile data collection. All accessible health facilities will be assessed starting 10 December.


WHO Grade 3 Emergencies  [to 9 December 2017]
The Syrian Arab Republic
:: Syria cVDPV2 outbreak situation report 25: 6 December 2017
[See Polio above for detail]

WHO Grade 2 Emergencies  [to 9 December 2017]
:: Diphtheria is spreading fast in Cox’s Bazar, Bangladesh
News release
6 December 2017 | Geneva – Diphtheria is rapidly spreading among Rohingya refugees in Cox’s Bazar, Bangladesh, WHO warned today.
More than 110 suspected cases, including 6 deaths, have been clinically diagnosed by health partners, including Médecins Sans Frontières (MSF) and the International Federation of the Red Cross (IFRC).
“These cases could be just the tip of the iceberg. This is an extremely vulnerable population with low vaccination coverage, living in conditions that could be a breeding ground for infectious diseases like cholera, measles, rubella, and diphtheria,” said Dr Navaratnasamy Paranietharan, WHO Representative to Bangladesh.
“This is why we have protected more than 700,000 people with the oral cholera vaccine, as well as more than 350,000 children with measles-rubella vaccine in a campaign that ended yesterday. Now we have to deal with diphtheria.”…

UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
Syrian Arab Republic
:: 7 Dec 2017   Syria IDP Operations Summary 2017 (Valid as of 7/12/2017) [EN/AR]

:: 4 Dec 2017  Statement by the Humanitarian Coordinator for Yemen, Jamie McGoldrick, Requesting a Humanitarian Pause [EN/AR]
:: Yemen: 2018 Humanitarian Needs Overview (HNO)
:: Yemen: Escalation of Armed Clashes and Airstrikes in Sana’a City – Update 1 | 04 December 2017
:: Statement by IASC Principals requesting the immediate lifting of the blockade | 2 December 2017

UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
:: ISCG Situation Update: Rohingya Refugee Crisis, Cox’s Bazar – 07 December 2017
WHO & Regional Offices [to 9 December 2017]
Uganda ends Marburg virus disease outbreak
News release
8 December 2017 | Geneva – Uganda has successfully controlled an outbreak of Marburg virus disease and prevented its spread only weeks after it was first detected, the World Health Organization said on Friday (December 8).
“Uganda has led an exemplary response. Health authorities and partners, with the support of WHO, were able to detect and control the spread of Marburg virus disease within a matter of weeks,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.
The Ugandan Ministry of Health notified WHO of the outbreak on October 17, after laboratory tests confirmed that the death of a 50-year-old woman was due to infection with the Marburg virus. A Public Health Emergency Operations Centre was immediately activated and a national taskforce led the response.
Three people died over the course of the outbreak which affected two districts in eastern Uganda near the Kenyan border, Kween and Kapchorwa. Health workers followed up with a total 316 close contacts of the patients in Uganda and Kenya to ensure that they had not acquired the illness…

Diphtheria is spreading fast in Cox’s Bazar, Bangladesh
6 December 2017 – Diphtheria is rapidly spreading among Rohingya refugees in Cox’s Bazar, Bangladesh, WHO warned today. More than 110 suspected cases, including 6 deaths, have been clinically diagnosed by health partners, including Médecins Sans Frontières (MSF) and the International Federation of the Red Cross (IFRC).

The Latvian eHealth Journey
December 2017 – In a journey that started over a decade ago, and in line with the 2013 World Health Assembly resolution on eHealth standardization and interoperability, the Ministry of Health of Latvia demonstrated its commitment to achieving Universal Health Coverage by creating a national programme of eHealth – which was seen as a key effort in ensuring that Latvian people receive the right care in the right place and time. The WHO Country Office in Latvia has provided coordination and technical support for Latvia’s eHealth efforts.

Recruitment for external members for WHO’s Guideline Review Committee
December 2017 – The WHO Guideline Review Committee (GRC) seeks new external members for the 2018-2020 term. The GRC oversees WHO’s quality assurance process for all of its guidelines (information products that contain technical recommendations across a wide variety of topics). GRC members serve a 3-year term and involves 40-50 hours of work per year, including virtual attendance at ten 2-hour monthly meetings and the performance of peer review of 3-4 documents.

New guidance on insecticide resistance monitoring and management
December 2017 – This framework provides guidance on developing a national insecticide resistance monitoring and management plan. It is designed to help countries ensure adherence to the Global plan for insecticide resistance management in malaria vectors.

WHO commends South African parliament decision to pass tax bill on sugary drinks
December 2017 – The South African Parliament has taken a brave and powerful step towards promoting the health of the country’s citizens and reducing diet-related noncommunicable diseases (NCDs), such as diabetes, by passing a bill to implement a tax on sugar-sweetened beverages, according to Dr Rufaro Chatora, WHO’s Representative to South Africa.

Fact Sheets
:: Meningococcal meningitis  Updated December 2017
:: Human rights and health  December 2017
:: Cholera   Updated December 2017
:: Dementia  Updated December 2017
:: Mental health of older adults  Updated December 2017

Weekly Epidemiological Record, 8 December 2017, vol. 92, 49 (pp. 749–760)
Schistosomiasis and soil-transmitted helminthiases: number of people treated in 2016
WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: The Marburg Virus Disease outbreak in Uganda is over   08 December 2017
:: Experts Call for Increased Investments to Drive Immunization Progress in Africa   08 December 2017
:: Momentum grows towards improved reproductive health services :  Experts pledge renewed commitment to scale up access to reproductive health services  08 December 2017
:: WHO supports ministry of health to train district rapid response teams in malaria surveillance, epidemic preparedness and response
:: WHO commends South African parliament decision to pass tax bill on sugary drinks  06 December 2017
:: World AIDS Day in South Sudan heightens campaigns to end AIDS by 2030  06 December 2017
:: With threat of famine looming for 2018, WHO helps worst cases of malnutrition in children in South Sudan   05 December 2017
:: Men urged to seek HIV & AIDS services at the World AIDS Day 2017 commemoration in Uganda  05 December 2017
:: WHO with support from Government of Japan strengthens blood transfusion services for safe, sustainable and quality blood in South Sudan  04 December 2017
:: Supporting breastfeeding to boost child survival  04 December 2017
:: South Sudan implements a road map to introduce and institutionalize National Health Accounts  04 December 2017
:: Botswana conducts a Joint External Evaluation to assess the country’s International Health Regulations (2005) core capacities  04 December 2017
:: The biggest AIDS Conference in Africa, opens in Abidjan, Cote d’Ivoire  03 December 2017
:: Dr Moeti calls for greater commitment to access, diagnosis and treatment for children and adolescents living with HIV/AIDS  03 December 2017
:: HIV experts take stock of progress and challenges in tackling HIV among children and young adults, ahead of ICASA   03 December 2017

WHO South-East Asia Region SEARO
:: Amid concern over drug resistance, Mekong countries call for accelerated action to eliminate malaria before 2030   SEAR/PR/1673
NAY PYI TAW, Myanmar 8 December 2017 – Representatives from Cambodia, China, the Lao People’s Democratic Republic, Myanmar, Thailand and Viet Nam today called for accelerated action to eliminate malaria in the Greater Mekong Subregion (GMS) by the year 2030.
The call comes amid concern over resistance of malaria parasites to antimalarial drugs, including artemisinin—the core compound of the best available antimalarial medicines. To date, resistance has been detected in five of the six GMS countries. The best way to address the threat posed by drug resistance is to eliminate malaria altogether from the countries of the Mekong.
At a high-level meeting convened by the Ministry of Health and Sports of Myanmar in collaboration with the World Health Organization (WHO) and the Asia Pacific Leaders Malaria Alliance (APLMA), representatives from the six GMS countries stressed that eliminating malaria in the Subregion requires urgent and coordinated action, with support from implementing agencies, funders and other partners.
Ministers from the six countries pledged to:
…ensure activities to eliminate malaria in the subregion are fully funded, including with more domestic funds;
…improve cross-border collaboration and establish an independent oversight body, for which WHO will act as the secretariat;
..strengthen systems for the identification and timely reporting of malaria infections, including drug-resistant forms;
…provide the best possible prevention, diagnosis and care for all people at risk of malaria, including free services for ethnic minorities and mobile and migrant populations, as part of universal health coverage;
..ensure available antimalarial medicines are safe and effective for use;
…bring all concerned sectors together to translate policies into time-bound and results-oriented actions; and
..engage communities in malaria elimination using innovative communication tools…
WHO European Region EURO
:: Challenging the supply chain to reduce sugar in foods 05-12-2017

WHO Western Pacific Region
:: Amid concern over drug resistance, Mekong countries call for accelerated action to eliminate malaria before 2030   SEAR/PR/1673